First trimester screening in Singapore is a routine prenatal test offered to all pregnant women. It is designed to identify women who are at high risk of having a baby with Down syndrome or other chromosomal abnormalities.
One such test is the OSCAR Test, or ‘One-stop Clinic for Assessment of Risk for Fetal Anomalies.’ In this article, we’ll dive into what the OSCAR Test is, how it’s conducted, and explore other first-trimester screening options available to you.
What Is OSCAR Test?
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For many expectant mothers, the first trimester of pregnancy is a whirlwind of medical tests and weeks of check-ups . The OSCAR Test, often a newcomer to the list of tests, may leave you wondering about its purpose.
The OSCAR Test is a first-trimester screening aimed at identifying the risk of fetal anomalies, with a particular focus on Down’s Syndrome (Trisomy 21). It’s important to note that this test is optional and is offered at all hospitals in Singapore.
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So how is OSCAR Test done?
The OSCAR Test involves two components: a Nuchal Translucency (NT) scan and a blood test. Your doctor will typically schedule this test between the 11th and 14th week of your pregnancy. Once the test is completed, your doctor will interpret the results and discuss the next steps with you. Depending on the outcome, you may choose to undergo further invasive testing such as Chorionic Villus Sampling (CVS).
OSCAR Test Singapore Fee
The cost of the OSCAR Test can vary between different hospitals in Singapore. To give you an idea, here are estimated prices from some hospitals:
- Thomson Medical – $310
- NUH – $350
- MT Alvernia – $330
This pregnancy OSCAR test is carried out in the first trimester to screen for the risk of foetal anomalies, particularly for Down Syndrome (Trisomy 21). It involves a Nuchal Translucency (NT) Scan and a blood test.
Another concern may be, how accurate is OSCAR Test? Also, how long does it take to get the OSCAR Test result?
The detection rate of Trisomy 21 by this method is about 90 per cent, with a false positive rate of 5 per cent.
- Procedure: Sample of mother’s blood and ultrasound scan
- Release period of result: About two to three working days
- Cost: ~$300+ at Thomson Medical Centre
Other First Trimester Screening Tests in Singapore
Aside from the OSCAR pregnancy test, there are other options for Down Syndrome screening in Singapore.
Down Syndrome screening in Singapore — Ultrasound scans and blood tests can help assess if your unborn child may have Down Syndrome.
1. Nuchal Translucency (NT) Scan
Nuchal Translucency is an ultrasound scan that measures the width of the spinal cord at the back of the baby’s neck. It takes place between the 10th and 13th week of pregnancy. Doctors also call it the First Trimester Screening. Doctors usually recommend this assessment as part of the Oscar Test.
- Procedure: Via an ultrasound scan
- Release period of result: Immediately after the ultrasound scan is complete.
- Cost: $267.50+ at NUH
Additional information on the NT Scan at National University Hospital (NUH) can be found here.
2. Triple Test or Maternal Serum Screening
The Triple Test measures a set of three hormones (alpha-fetoprotein, HCG and Oestriol) in the blood of the pregnant mother. The test calculates a risk value based on the maternal age and the gestational age of the foetus at that time.
Compared to the OSCAR Test, it’s usually done around between 14th to 18th week of the pregnancy. Doctors also refer to it as the Second Trimester Screening. Its accuracy is only 65 per cent, which is why this test is less popular.
- Procedure: The medical practitioner takes samples of the mother’s blood.
- Release period of result: About seven working days
- Cost: $149+ at Singapore General Hospital (SGH)
You can find more information on the Triple Test or Maternal Serum Screening at the SGH here.
3. MaterniT21 Plus
MaterniT21 Plus is a new foetal DNA test launched in June 2013. It claims to have an even higher detection rate than the current first-trimester screenings.
Dr Ann Tan, a gynaecologist and obstetrician who chairs the obstetrics and gynaecology speciality interest group of Mount Elizabeth Hospital, claims that the MaterniT21 Plus is 99 per cent accurate because it looks for the baby’s DNA and not the mother’s hormones.
Expectant mothers can do the new test as early as week 10 of pregnancy. This is earlier than the OSCAR Test, which is done between the 11th-14th week.
These screening tests are usually done as early as possible, in case there is a need to terminate the pregnancy. However, this test does not replace the old blood test and nuchal scan.
- Procedure: The medical practitioner will take a sample of the mother’s blood.
- Release period of result: It takes about 10 working days or about two weeks after the samples go to the laboratory.
- Cost: $3,000+ at Parkway Health Laboratory
Click here for more information on MaterniT21 Plus.
Down Syndrome screening in Singapore — Through the analysis of the mother’s blood samples, doctors can assess the risk of Down Syndrome in the unborn child.
4. Non-Invasive Prenatal Tests (NIPT)
Available since late 2013, doctors can detect signs of Down Syndrome by obtaining the baby’s DNA through the mother’s blood sample.
Dr Chua explains, “NIPT uses the maternal blood test to detect DNA from pregnancy. There is 99 per cent accuracy with a low false-positive of 0.1 per cent.”
There are two types of NIPT in Singapore, namely Harmony Test and Panorama Test. The Harmony Test can take place from week 10 onwards of the pregnancy. Meanwhile, the Panorama Screening tests can be done from the ninth week.
The test should only be taken if a mother is classified as high-risk in first-level screening tests, which is about five per cent of all pregnant mothers.
- Procedure: The medical practitioner takes samples of the mother’s blood.
- Release period of result: It takes about 10 to 14 working days after sending the samples to a laboratory
- Cost: Harmony Test (~$1,200+), Panorama Screening (~$1,400+) at Thomson Medical Centre
*Check with your gynaecologist on which screening is suitable for you. Each doctor and hospital has varying facilities and your gynaecologist would be able to advise where to go for certain tests.
My Test Reveals High Risk Of Down Syndrome, So What Now?
If the OSCAR pregnancy test or another screening test indicates a high risk of Down Syndrome, diagnostic tests may be performed to determine whether the baby actually has Down Syndrome. These are usually invasive options and pose a higher risk for both mother and baby.
Types of Diagnostic Tests
-
Amniocentesis
- Procedure: The medical practitioner will withdraw a sample of the amniotic fluid surrounding the baby through a needle inserted into the mother’s womb. This ensures the result’s accuracy is close to 100 per cent. The test results arrive in about two to three weeks.
- When: after 16 weeks of gestation
- Risk of miscarriage: 0.1 to 0.3 per cent or about one in 300 women
-
Chorionic Villous Sampling (CVS)
- Procedure: A sample of cells from the mother’s placenta is taken to analyse the baby’s genes, ensuring accuracy results of close to 100 per cent. Expect results within 48 hours to one week.
- When: between weeks nine and 14 of pregnancy
- Risk of miscarriage: approximately one in 200
-
Percutaneous umbilical blood sampling (PUBS) or Cordocentesis
- Procedure: This test involves taking a blood sample from a vein in the umbilical cord and examining blood cells for chromosomal defects. But due to its significantly higher risk of a miscarriage as compared to the previous two diagnostic tests, this is only offered as an alternative option. They employ this test when there are unclear test results from other methods.
- When: after 18 weeks of gestation
- Risk of miscarriage: 1.4 to 1.9 per cent
Who Are At Higher Risk?
The risk of Down Syndrome is directly related to the mother’s age. The older the mother, the higher the risk. For example, a 20-year-old woman has a one in 1,500 risk of having a baby with Down’s syndrome. In comparison, a 35-year-old woman has a one in 270 risk.
Additionally, about one in 100 women with a previous baby with Down Syndrome will have another. As Dr Chua points out,
“Older mothers, history of Down Syndrome in a previous pregnancy or family history of Down Syndrome [and] history of recurrent miscarriages which could be due to translocation abnormalities (i.e. scrambled chromosomes) put the risk of Down Syndrome at a higher level.”
Dr Chua also notes that there is a slightly higher risk in boys than girls, too.
There is no treatment or prevention method available for Down Syndrome. But there are a lot of available Down Syndrome screening tests in Singapore including the OSCAR Test. Because of these, fears may be allayed and parents are able to make appropriate choices for their family.
Mums, which Down Syndrome screening test did you choose? Do share your reasons for going for testing below!
Updates by Romy Pena Cruz
WHO, HPB, KKH, Mayo Clinic, Mayo Clinic, Palomaki, Glenn, Lee, Jo Ellen, et.al., Nature.com, Genetics in Medicine (2009) 11: 669–681. Web 17 August 2009.
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